‘Flurona’: when flu and covid strike at the same time

The junction of the H3N2 flu epidemic with the covid-19 pandemic is resulting in situations where the two diseases occur at the same time. The coinfection already has a nickname, “flurona”, a mixture of coronavirus with flu (flu in English). Hundreds of cases have already been reported in different Brazilian cities.

First of all, it is important to point out that this is not a new disease, although the term conveys that impression. Catching more than one virus and bacteria is common. “This is an old phenomenon, which can occur with other respiratory viruses besides influenza and Sars-Cov-2 (Covid-19 virus), as they are transmitted in a very similar way,” the World Health Organization said in a statement. Health (WHO).

In addition to the contagion being similar – through contact with respiratory droplets and contaminated surfaces – flu and covid have now joined for extra reasons. There was a low adherence to influenza vaccination throughout 2021 and a relaxation of distancing measures in recent months, which coincided with the arrival of a more transmissible variant of the coronavirus, Ômicron, opening space for the spread of the two diseases.

With all these possibilities in the air, the fact that when the unprotected individual catches a virus, their body is weakened still weighs. Therefore, more vulnerable to other microorganisms. “The second infection can occur during the incubation period of the first, when there are still no symptoms, so people don’t realize it”, warns the WHO.

There is still not enough information to say whether cases of co-infection are growing across the country, and it is important to have tests available to gather this data, defend the experts. Another point that makes adequate surveillance difficult is access to numbers from the Ministry of Health. Since December, the system has suffered from instability after a widespread blackout.

Symptoms and diagnosis

Just doing a test to make sure there is a co-infection. There is the possibility of carrying out the RT-PCR or antigen test for each virus, or paying for a more complete analysis, which distinguishes four viral infections.

In addition, few clues in the symptoms can raise suspicion. “When, for example, a very high fever occurs in the first few days, which is more characteristic of influenza, and there is an unexpected worsening later, pointing to covid”, shows a report by the Brazilian Society of Infectious Diseases (SBI).

Studies try to differentiate the signs of the two diseases, but mutations in the viruses complicate the scenario. “It depends on each individual as well. Covid-19 causes concern when there is fever and low saturation, but there are cases of Ômicron that attack the digestive system more, which can also occur with influenza infection”, points out the SBI.

To complicate matters, a material recently published in The British Medical Journal by the UK government points to a runny nose, headache and fatigue as the most prevalent signs of the new variant – complaints quite common in other viral infections.

That is, when in doubt, it is important to seek tests and medical attention when there are signs of an acute respiratory condition: fever, chills, sore throat, headache, cough, runny nose, smell or taste disorders. Until the differentiation is made, the condition is treated as flu syndrome, a generic term that encompasses these diseases.

How is the treatment?

If the symptoms and the form of transmission are similar, each disease has different protocols – hence the relevance of tests, as already mentioned. “It changes the way it evolves, the possible treatments and the isolation protocols, so it is important to know which virus we are dealing with”, reinforces the SBI.

The coronavirus still doesn’t have a specific antiviral approved in the country, but there are drugs that can serve some serious cases. The flu has oseltamivir, an antiviral that works against influenza, but which also has a very specific protocol for use and is not a silver bullet. The isolation protocol is seven days when the infection is by influenza and 14 days if it is covid.

Could the coinfection be more serious?

Even before the Covid vaccine was a reality, an English study warned that those infected with the coronavirus would have twice the risk of dying if they contracted the flu. With immunization, however, the picture changes.

“We know that vaccines are doing their job well, which is to prevent serious cases and deaths. A person with co-infection may have milder symptoms of covid because they are protected, but they may feel more damage from influenza. In any case, two infections can overload the organism”, evaluates the SBI.

The SBI also reminds that the risk groups for each disease need extra attention. For covid, it’s the elderly. For influenza, children under 5 years old, and also the elderly. People with comorbidities and immunosuppressed individuals are more vulnerable in both cases.

There are still not enough studies to know whether a young person in good health can have the condition worsened by co-infection.

How to protect yourself?

With the arrival of Ômicron, the ideal is to guarantee the complete vaccine scheme of covid, which includes the third dose. Since it is known that only the three doses can provide more effective protection against the new variant.

The influenza vaccine is being applied in some regions, even though it does not contain the new strain of H3N2. It’s worth taking it too. “There are studies pointing out that the Hong Kong variant, present in the immunizer, is very far from Darwin, which causes the current outbreaks. But, as we are experiencing an epidemic, it is recommended that you take this dose to be at least partially protected”, clarifies in a note the Brazilian Society of Immunizations (SMIm).

An updated vaccine containing the new strain is expected to arrive in mid-March. A month interval between the two injections is recommended, so you can vaccinate yourself with the dose available now, between January and February.

It is good to remember that vaccines are part of a set of other protective measures. In this scenario of high circulation of two viruses, wearing a mask, avoiding agglomerations and washing your hands often are still priorities, reinforce the experts.